Lifestyle Change Program Registration

Spring 2024 Orleans County

Welcome to the Lifestyle Change Program to help prevent or delay type 2 diabetes. If you are interested in participating in this life-changing program and will commit to 1 hour a week for 6 months and 1 hour a month for the second 6 months please continue.

There is no registration fee.

Individuals learn skills to make lasting lifestyle changes, including healthy eating, adding physical activity to their lives, how to manage stress, and how to stay motivated.

Please bring a notebook with you to hold your materials on the first day of our workshop. You will be weighed and if you like, we can do baseline measurements of your chest, waist, and hips. We will go over the workshops and have some time to get to know one another.[KP1]

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* 1. Name

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* 2. Date of Birth / Age (XX/XX/XXXX and current age)

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* 3. Email

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* 4. Phone number

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* 5. What is your mailing address? (Please include street, town/city, state, and zip code)

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* 6. Have you been told...

You are at risk of Type 2 Diabetes

You have Prediabetes

You are overweight

Nothing, but you are interested in changing your eating and physical activity

Other (please specify)

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* 7. How did you hear about this?

I took the interest survey I saw on social media

From the article in the Orleans Hub / The Daily News / Video News Service

From my primarycare provider

From a friend

From a Health Department staff member

Other (please specify)

To learn more about the Lifestyle Change Program feel free to e-mail NDPP@orleanscountyny.gov or visit the CDC website.

Thank you for registering for the Lifestyle Change Program we will be contacting you with further details soon.